Royal Decree 3,/ Ministerio de Economía. Real Decreto 3,/ de 11 de noviembre por el que se crea el Fondo de Garantía de Depósitos . Decree 3,/, which regulates social welfare in Brazil, defines that the main attributions of Vocational Rehabilitation are (Brasil, BRASIL. Decreto nº. Download as PDF, TXT or read online from Scribd. Flag for . DECRETO DE 28 Aug Por medio del cual se modifica el Decreto de.
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Vocational rehabilitation aspires to provide means for workers to reenter the job market, being associated with health, education, and labor and employment. Data were collected through a questionnaire sent to occupational therapists, as well as through interviews with some of them. We discussed themes that were categorized to analyze their practices and concepts and highlighted topics that allowed us to reflect on the limits, possibilities and challenges faced by these workers, examining the structure of the program as well.
A number of factors imply that their performance at the INSS is more negative than positive, which could be related to structural issues of the program. However, the therapists believe in improving its structure and point out the need to increase the possibilities offered, allowing for a greater participation and responsibility of companies, for more combined efforts with other government sectors and the civil society and for the expansion and reformulation of the Brazilian legislation on vocational rehabilitation.
They are entitled to Vocational Rehabilitation 11 11 The authors chose to use the expression Vocational Rehabilitation with capital letters when referring to the field and to the Program of the INSS, using lowercase for the practice within the field.
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Vocational Rehabilitation is also a duty according to Normative Instruction 45 fromarticle Sickness benefits will be suspended when the insured stops their medical exams, treatments and the process of vocational rehabilitation provided by the Social Welfare system, except for surgical treatment and blood transfusion, being reinstated the decretk the motive that caused the suspension ceases to exist, as long as the incapacity remains Brasil, c BRASIL. Instituto Nacional do Seguro Social.
As such, this article discusses the possible contributions of occupational therapy, with its technical and political aspects, for dealing with the demands related to the processes of decreasing the work capacity of the subjects and actions that may lead them back to baiixar activities. Based on these reflections and on the work of Vocational Rehabilitation, we aimed at understanding how occupational therapy contributes to the return of individuals to work, within the Bwixar of Vocational Rehabilitation of the INSS.
Vocational Rehabilitation is the field of knowledge production and development of propositions and actions linked to the processes of returning to work needed by individuals that for many reasons require interventions to restart their professional lives, whether in common work activities – for those, adaptations and adjustments may be made – or through preparation for starting a new job.
The field works as an interface between the Social Welfare system, Health, Education and policies and actions of Labor and Employment. Their coordination is necessary to prepare the insured for their return to the labor market, which usually involves following their condition through the health network, investing in improving or restructuring their education and their preparation in institutions of vocational education.
The proposition and creation of the Worker’s Health Reference Centers CEREST do not ensure its effectiveness and its potential for health promotion due to bureaucracy and slowness of the health sector.
Their services are often restricted baixr death counting and “posthumous” surveillance of the worker’s health, and it is difficult to implement health promotion and surveillance as defined by the National Worker’s Health Vaixar Carvalho et al. Revista Uniandrade, Curitiba, v. As a result, the field of Worker’s Health was constituted posteriorly to Vocational Rehabilitation and assumed a critical position due to the concepts and attention given to Brazilian workers at the time end of the sespecially in the health sector.
The health sector was then expanded to include vocational rehabilitation measures, with the purpose of developing interventions that did not decfeto workers as their only object and that took into account, as stated by Lacaz, LACAZ, F. In this sense, Collective Health is considered a nucleus demarcation of the identity of an area of knowledge and professional practice of the field of Health, which has as some of its main attributions: Hence, we believe that Vocational Rehabilitation, in its interface with Workers’ Health, should dedreto analyzed and organized based on these principles and attributions instead of focusing solely on repairing actions, which certainly can also be applied to Occupational Therapy.
According to Lancman et defreto. In Brazil, the vocational rehabilitation of individuals incapacitated for work was one of the main reasons for the formation of occupation therapists, together with practices at homes aimed at institutionalized people, either with mental disorders or disabled.
In spite of the origin of occupational therapy being related to the field of Vocational Rehabilitation, there is a lack of studies that link both of them.
Ina literature review carried out by the two main Brazilian journals in the area – Cadernos de Terapia Ocupacional from UFSCar and the Revista de Terapia Ocupacional from USP – showed that only two publications mentioned the theme, with just one of them discussing the contributions of occupational therapy for the field. A new manual analysis of both journals indicates that this reality remains unaltered.
Moreover, it allowed us to observe important characteristics of the work processes in large urban centers such as the large population, partially due to the search for work and employment relationships, the considerable amount of psychosocial care units for workers and the phenomena of illness and work accidents. This is an exploratory research, since studies and publications on the topic are lacking, and it had the purpose of getting closer to the studied reality to explain it, leading to reflections about it.
Moreover, its nature was descriptive and comprehensive as it aimed at explaining the characteristics of a specific phenomenon beyond the study of the relationships among the variables, including other ways to understand it Gil, GIL, A.
Como elaborar projetos de pesquisa. After these answers were tabulated, we conducted in-depth interviews with six of these therapists to enhance the reflections on the themes of the questionnaire.
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Lastly, an occupational therapist that had been working at the Institute since also gave us an interview, providing a historic survey of Vocational Rehabilitation and of the work of occupational therapists within the INSS and defending the incorporation of occupational therapy into the INSS.
The questionnaire encompassed 76 questions, and most of them were closed-ended and multiple choice, with the possibilities of choice varying between one or more alternatives.
In addition, some of them had space for commentary and additional observations. The last two questions were open-ended and allowed participants to discuss more freely the Vocational Rehabilitation of the INSS and occupational therapy in the area. The main topics discussed were: Moreover, an interview script was elaborated to provide more details on these topics 16 16 The script was constituted of the following topics: Studies on vocational rehabilitation, occupational therapy and work, and occupational therapy and vocational rehabilitation were also part of these references.
The interviewed occupational therapists were selected based on convenience sampling carried out through an analysis of the answers to the questionnaires – especially of the parts in which they could write about the topics. The purpose was to conduct a more in-depth conversation with the therapists that had shown interest. Seven in-person interviews were conducted and the reports were registered through a digital voice recorder and completely transcribed.
Initially, we chose one of the interviews as reference and after reading it many times we were able to define the themes that were used as data categories, which increased as the other interviews were read. As the selected interview was very comprehensive, new categories were identified only in the reading of the second interview. The contents that resulted from this categorization and systematization were studied and discussed using the theoretical references that guided the research, and they were also linked to the findings obtained from the application of the questionnaire.
This article presents part of these results and discussions with the purpose of analyzing the challenges and possibilities of Vocational Rehabilitation in the INSS, focusing on the practices and concepts of occupational therapists that work in the area.
We will present data referring to the questionnaires, providing a general overview of the topics studied by the research and especially those that resulted from the in-depth interviews, owing to relevant markers found on the reports of the interviews therapists. To contextualize these reflections, we initially make some observations on the situation of Brazilian workers and on the transformations seen in the labor market and in Vocational Rehabilitation in the country.
Ensaio sobre as metamorfoses e a centralidade do mundo do trabalho. When discussing the lacking structure of work on a global scale, the author affirms that the Brazilian circumstances are dire, and that during the s the industrial and service sectors went through a significant productive restructuring owing to the new international work division, which required changes in production organization and in its processes of territorial redistribution. Automation, robotics and microelectronics were developed during a recession period and caused many workers to leave the workforce, and the proposals of more flexibility, deregulation, and privatization gained strength with the federal neoliberalism of the late s and early s Antunes, ANTUNES, R.
The informal labor market increased, violating labor law and causing many employees to stop earning wages and start working without any employment registration.
Similarly, starting from the s, the number of outsourcing companies that provide temporary workforce increased significantly in the country, aiming to meet the large demand of the private market for temporary workers, with no employment registration or relationship Antunes, ANTUNES, R. It is necessary to discuss those who do not work, not because they are not capable, but because there is no work for them – there is no place for these individuals who are stuck between the obligation of working and the impossibility of doing so according to regulations.
The new attributions incorporated by LOPS included educational care and assistance for the vocational adaptation of the insureds receiving sickness benefits, retired workers and invalid pensioners Soares, SOARES, L. You made an evaluation and there were some procedures to follow with the protocols to evaluate the insured, outlining the program that they would follow on the short, medium and long term and the prognosis for the process.
We provided treatment at the Vocational Rehabilitation, working with joint mobility, muscular strength, coordination, training ADLs [Activities of Daily Living] and IADLs [Instrumental Activities of Daily Living], in addition to assessing their return to work, which was the last thing we did, obviously.
This approach was the last one, more directly related to the Workshop.
We attended only the beneficiaries part of the Vocational Rehabilitation Program which were sent by the 19 Groups of Medical Experts. The Institute was responsible for managing the social contributions destined to the financing of social security, in addition to guaranteeing the baizar the worker had to to receive the benefits managed by it, no longer defining the healthcare which so far had been carried out by INAMPS Soares, SOARES, L.
Its goals encompassed readopting a more comprehensive perspective of the process of Vocational Rehabilitation and of policies on the health of workers, together with the Bwixar of Health, Labor and Employment and Education, proposing a new creation and training of multidisciplinary staffs. Thus, in a total of civil servants were admitted to work as Social Security Analysts with a degree in Occupational Therapy, starting the process of recreating these staffs 19 19 See: During the interviews, work was mentioned as a central element in the chain of signified and signifiers of human making, which is in accordance with the centrality of work mentioned by Castel, CASTEL, R.
The following topics were discussed: Part of the interviewees said their work is important to transform the dwcreto view of the insureds. The issue is very delicate, since a concept of work constructed throughout an entire career cannot be deconstructed – nor should it be – due to risky conditions decrrto the labor market and to the fact that many of these workers did not have the possibility of assigning different meanings to their work regarding the choice of what to do or exercising their potential.
We believe a combined effort is required to help workers go through a path that leads to a new professional activity, based on their vocational abilities and beliefs regarding work, considering the complexity inherent to decdeto process. With their answers to the questionnaire, occupational therapists mentioned that the following aspects of the insureds compromise the process or make it harder: Bakxar specifically, the interviewees expressed other fundamental issues vecreto the difficulties faced by the insureds regarding their perspectives of returning to work, such as a work history based on heavy activities and the fear of unemployment.
Their largest concern is not related to working, but to not finding any work. The relationships that individuals create with and in their work are fundamental decrteo for the constitution of their character, since they enable the experience of belonging and setting long-term goals for their lives Sennett, SENNETT, R.
In the current workforce, where conditions are becoming increasingly precarious, and in the case of Vocational Rehabilitation with its restrict possibilities, these elements are permanently menaced since there are no guarantees that the individuals will stay on their workplaces, and many insureds do not feel sufficiently confident to perform activities they were not rehabilitated to perform. None of them classified it as excellent. Moreover, the therapists expected having more significant interventions inside the companies, which would baixae from increasing the analyses of work posts to bringing vaixar regarding the principles, goals and actions of Vocational Rehabilitation.
Hence, more contact with companies, informing their managers and other employers about the legislation and the dcreto experienced by workers on, as well as their potentials, and creating opportunities for trainings of vocational dcreto for positions compatible with these potentials are essential for the insureds to return to work performing activities that leave both employee and company satisfied.
The occupational decret of the INSS were aware of the difficulties of preparing workers to return to work, for there are no guarantees, and the mechanisms that should ease their return and ensure their stay in the labor market are lacking. Moreover, they know that the lack of confidence and the resistance of some insureds regarding their participation in the Program is related to issues that do not pertain to the universe and possibilities of the INSS, as they have little to offer in comparison with their real demands.
However, although the process of returning to work is often interpreted based on its inherent complexity, with at least a partial understanding of its many factors, the therapists see that the only possibility is a job appropriate for the individual, depending on how they are able or capable to adapt to a new work situation in the company with which they have an employment relationship.
Nonetheless, we propose the challenge of defending the right to work with dignity, within the context of Vocational Rehabilitation in the INSS, in which returning to companies with employment relationships decdeto the priority since it is the most effective way to exercise this right. Hence, it is a possibility for insureds to return to the labor market without any employment relationship, or to stay at the companies in which they have this relationship.
Some of the interviewees were satisfied with this possibility, others were not completely accepting of such a law, for companies should be socially responsible for the lower work capacity of their employees, which is mostly due to the work activities they performed. Moreover, they mentioned the fact that Brazil does not have any mechanisms that promote an effective return of these people decrdto the labor market through a combined effort of baoxar Ministries of Social Security and Labor and Employment.
As for the Technical Manual of Treatment in the Area of Vocational Rehabilitation, a document that guides the actions of the Programs, the interviewees refer both to the need to standardize the procedures after the decentralization of the Vocational Rehabilitation for Executive Managements and Agencies of the Institute and to the structural inflexibility of the instrument, which limits part of the actions the therapists deem the most appropriate in certain situations.
It is necessary to reformulate the laws on Vocational Rehabilitation and the social protection of workers to go beyond ensuring a few rights which are limited to a year of job security in cases of work accidents or vocational 348 and mechanisms that compensate the insertion such as the Quota Law. The Institute is obliged to train the insureds for the labor abixar, and the insureds are obliged to participate in the Vocational Rehabilitation.
Other measures are required to guarantee better conditions for workers in their return to work and stay at work, not only for rehabilitated individuals, but for the entire Brazilian working class. The interviewed participants brought up the importance of considering that each insured needs a different amount of time to accept their new 348 condition – being on work leave – as well as for understanding and accepting the Program. The relevance attributed to the relationship created with the insureds during the entire process is observed from derceto initial evaluation to the moment they are disconnected from the program, which allows the therapists to take into account the issues they consider most relevant, in spite of the inflexibility of the procedures.
In addition, some statements considered that Vocational Rehabilitation, despite of its limitations and the life conditions of the insureds, which are usually hard, may represent an opportunity to choose a new work path and to even create new relationships with work. Moreover, they singled out the difficulty in providing rehabilitation for a position that usually generates an income that is lower than the income they had before the leave, and the need to inform the insureds about the real possibilities offered by the Program and the challenges they will face when returning to the labor market.
The occupational therapists knew that many events were related to the process of preparing the insureds to start a different work from what they were used to, and they were capable of identifying most of them.
In a certain measure, they have been able to insert other elements in the combined eecreto and decisions regarding decretp projects elaborated together with biaxar insureds, but most of the times baixae work decreti limited and carried out by struggling with the required procedures.
Nevertheless, the identification of the events and the fact baixzr in some moments they are considered during the elaboration of the projects for bringing the insureds back to work is an important advancement, as it goes beyond the work incapacity that focuses on the limitations caused by their clinical state.
We highlight that the occupational therapists listed some characteristics the insureds should have, or the need to prepare them for acquiring them, in order that their return to work is effective. Moreover, they should know the labor market so that they become more capable to meet the existing baixxr.
However, they did not mention that this type of action is not very effective in an unstable and excluding labor market, and when the legislation for the social protection of workers is lacking. It is necessary to expand the concept of training aimed at the labor market, which should not be limited to the characteristics and abilities of the insured, although the possibilities for considering issues beyond those in the daily life of the Program are insufficient.
At the end of the answers to the questionnaire, the participants had the possibility to express their opinion regarding their belief or lack thereof in the Vocational Rehabilitation Program. From the 37 therapists which decided to do so, five said they did not believe secreto the program and 32, i.
Decretl the in-depth interviews, a decgeto aspects of Vocational Rehabilitation were decretl up, such as: